1. RITES OF PASSAGE

2. LGBTQ HEALTH-RELATED ISSUES

3. LGBTQ YOUTH  Denied many adolescent “Rites of Passage”  Fewer role models  Lack of healthy outlets for sexual exploration  Missing these experiences can stifle normal development

4. LGBTQ IN THE CLASSROOM

5. WHAT’S HAPPENING?

6. WHY IT MATTERS…

7. LGBTQ AND TOBACCO USE  LGB have significantly higher smoking rates compared to heterosexuals  Why?? Coping with stress from stigma, discrimination Among youth – seeking social acceptance while coping with social isolation, loneliness Bars, clubs have historically been primary social outlets for LGBT  Negative consequences Cancer C-V disease

8. TARGETING OF LGBTQ BY THE TOBACCO INDUSTRY

9. LGBTQ - SUBSTANCE USE & ABUSE  Lesbian/bisexual women More alcohol-related problems Heavier alcohol use Greater lifetime rates of marijuana, cocaine & other illicit drugs May not decrease with age African-Americans o Heavy drinkers o More problems  Transgender women (male-to- female) Limited information

10.  Gay/bisexual men Greater lifetime use of cocaine, MJ, ecstasy, methamphetamine, poppers Similar alcohol rates compared to heterosexual men  Negative consequences C-V disease Risky sexual behavior LGBTQ -SUBSTANCE USE & ABUSE

11. SEXUALLY TRANSMITTED INFECTIONS – GAY MALES  HIV/AIDS Continues to have a profound effect both physically and psychologically on this community. FDA bans gay men from participating in blood drives and sperm banks CDC reports over 50% of all new MSM HIV infections are in youth ages 14-24. HAART medications  Other STIs Chlamydia/LGV Viral hepatitis (A & B) HSV HPV (urethral, anal) MRSA

12. SEXUALLY TRANSMITTED INFECTIONS – LESBIANS  Limited information Also had sex with men May be at higher risk  WSW can transmit Bacterial vaginosis Chlamydia HSV-1 HPV Trichomoniasis

13. LGBTQ AND DISORDERED EATING/OBESITY  Lesbians/bisexual women – mixed data  Eating habits among lesbians may be less healthy  Gay/bisexual men Higher prevalence disordered eating Higher body dissatisfaction Social pressure to conform to physical ideals is pervasive

14. LGBTQ AND CANCER  Lesbian/bisexual women Cervical cancer o Less frequent Pap tests o Cervical cancer Breast cancer o Less frequent mammograms o More risk factors Ovarian and endometrial cancer o Decreased number of pregnancies o Decreased use of oral contraceptives  Gay/bisexual men Anal cancer o Receptive anal intercourse = highest risk o HIV-infection increases risk  Transgender Hormones

15. THE DATING GAME

16. LGBTQ AND VIOLENCE  Hate Crimes: Victims of more violent physical assaults  Domestic Violence: Similar rates of DV among same-sex couples  Sexual Assault

17.  May have increased risk for Depression Anxiety/panic attacks Suicidal behavior  Why? Stigma, negative societal views Internalized homophobia Unfavorable views of bisexuality “Covering” Victimization Social isolation Problems with self-acceptance LGBTQ MENTAL HEALTH CONCERNS

18. STARS

19. RESOURCES 1.American Medical Student Association’s LGBT Health Action Committee (www.amsa.org/gender)www.amsa.org/gender 2.GLMA – Gay & Lesbian Medical Association (www.glma.org)www.glma.org 3.Gay Health (www.gayhealth.com)www.gayhealth.com 4.Lambda Legal (www.lambdalegal.org)www.lambdalegal.org 5.GLBT health Access Project (www.glbthealth.org)www.glbthealth.org 6.Bisexual Health (www.biresource.org/health/)www.biresource.org/health/ 7.Transgender Care (www.transgendercare.com/default.asp)www.transgendercare.com/default.asp 8.Intersex Society of North America (www.isna.org)www.isna.org 9.PFLAG – Parents, Family & Friends of Lesbians and Gays (www.pflag.org)www.pflag.org 10.HRC - Human Rights Campaign (www.hrc.org)www.hrc.org 11.GLAAD - Gay and Lesbian Alliance Against Defamation (www.glaad.org)www.glaad.org 12.NGLTF - National Gay and Lesbian Task Force (www.ngltf.org)www.ngltf.org 13.Stall RD, Greenwood GL, Acree M,& Coates TJ Cigarette smoking among gay and bisexual men, Am J Public Health 1994: 89:1875-1878. doj:10.2105/AJPH.89.12.1875 14.Skinner WF. The prevalence and demographic predictors of illicit and licit drug use among lesbians and gay men. AM J Public Health 1994:84:1307-10.

20. RESOURCES(CONTINUED) 15.Cochran SD, Mays VM, Bowen D, et al. Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women. Am J Public Health 2001:91:591-7 16.Skinner WF, Otis MD. Drug and alcohol use among lesbian and gay people in southern U.S. sample: epidemiological, comparative, and methodological findings from the Trilogy Project. J Homosex 1996:30:23-37. 18.Ryan H, Wortley PM, Easton A, et al. Smoking among lesbians, gays, and bisexuals: a review of the literature. Am J Prev Med 2001:21:142-9. 19.Lee JG, Griffin GK, Melvin CL. Tobacco use among sexual minorities in the USA, 1987-May 2007: a systematic review. Tobacco Control 2009:18:275-282. 20.Tang H, Greenwood GL, Cowling DW, et al. Cigarette smoking among lesbians, gays, and bisexuals: how serious a problem? Cancer Causes Control 2004:15:797-803. 21.Hughes TL, Eliason M. Substance use and abuse in lesbian, gay bisexual, and transgender populations. J of Prim Prev 2002:22(3):263-298.

21. RESOURCES(CONTINUED) 22.Rath JM, Villanti AC, Rubenstein RA, Vallone DM. Tobacco use by sexual identity among young adults in the United States. Nicotine and Tobacco Research 2013:15(11):1822-1831. 23.Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation identity and gender differences in adult health. Am J Pub H 2010:100:1953-1960. 24.Healthy People 2020(2012). 2020 objectives: lesbian, gay, bisexual, and transgender health. Retrieved June 1, 2012 from 25.www.healthpeople.gov/2012/topicsobectives2020/overview.asp?topic=25www.healthpeople.gov/2012/topicsobectives2020/overview.asp?topic=25 26.http://www.lung.org/stop-smoking/tobacco-control-advocacy/reports-http://www.lung.org/stop-smoking/tobacco-control-advocacy/reports- resources/tobacco-policy-trend-reports/lgbt-issue-brief-update.pdf 27. http://www.cdc.gov/lgbthealth.comhttp://www.cdc.gov/lgbthealth.com 28.https://medschool.vanderbilt.edu/lgbti/health/hearthttps://medschool.vanderbilt.edu/lgbti/health/heart 29. http://www.ncbi.nlm.nih.gov/pubmed/13678808http://www.ncbi.nlm.nih.gov/pubmed/13678808 30. Substance Abuse and Mental Health Services Administration, Top Health Issues for LGBT Populations Information & Resource Kit. HHS Publication No. (SMA) 12-4684. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012. 31. GLESN 2009 National School Climate Survey

22. RESOURCES (CONTINUED) 32.http://www.pflagnyc.org/safeschools/statisticshttp://www.pflagnyc.org/safeschools/statistics 33. http://data.lambdalegal.org/pdf/158.pdf http://data.lambdalegal.org/pdf/158.pdf 34. Blashill A. The Fenway Institute. 2013.